Solution Architect- Epic STARS

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

The Solution Architect, Epic STARS is responsible for the design, optimization, and strategic direction of Epic-based solutions supporting Medicare Star Ratings, HEDIS, and NCQA quality measure performance. This role bridges clinical quality strategy and technical Epic build, ensuring that quality measure workflows, data capture, and reporting infrastructure within Epic Healthy Planet and related modules accurately support Star Ratings improvement initiatives across the organization. The ideal candidate combines deep Epic technical expertise with a strong understanding of value-based care, population health, and quality measurement methodologies.

• Architect and design Epic Healthy Planet, Reporting Workbench, Clarity/Caboodle, and SlicerDicer solutions to support Medicare Star Ratings, HEDIS, and NCQA measure tracking and gap closure.
• Translate quality measure specifications (CMS Star Ratings, HEDIS technical specifications, NCQA requirements) into functional and technical Epic build requirements.
• Design scalable data models and reporting frameworks that support accurate, auditable quality measure calculation and Star Ratings performance monitoring.
• Own the end-to-end technical roadmap for Epic STARS-related builds, including registries, care gap alerts, best practice advisories (BPAs), and health maintenance topics tied to Star measures.

• Partner with Quality, Population Health, ACO, and clinical leadership to understand measure priorities and translate business needs into Epic solutions.
• Serve as the primary technical liaison between clinical quality teams and Epic build/development teams for all Star Ratings initiatives.
• Collaborate with data analytics and reporting teams to ensure quality measure data feeds are accurate, timely, and aligned with CMS submission requirements.
• Present architectural recommendations, risk assessments, and solution options to senior leadership and governance committees.

• Lead or oversee Epic build activities related to Star Ratings measures, including registries, health maintenance plans, documentation flowsheets, and quality dashboards.
• Evaluate existing Epic workflows for gaps in quality measure capture and recommend workflow or build optimizations to improve Star performance.
• Ensure interoperability between Epic and external quality reporting platforms or vendor tools (e.g., HEDIS engines, risk adjustment vendors) using FHIR/HL7 standards where applicable.
• Conduct testing, validation, and troubleshooting of quality measure logic to ensure accuracy of Star Ratings-related reporting.

• Maintain thorough documentation of Epic STARS architecture, data flows, and build decisions to support audit readiness and knowledge continuity.
• Ensure solutions comply with CMS, NCQA, and internal data governance standards.
• Participate in change control and release management processes for all Star Ratings-related Epic builds.

• Stay current on CMS Star Ratings methodology changes, HEDIS specification updates, and Epic Healthy Planet roadmap enhancements.
• Identify opportunities to leverage new Epic functionality (e.g., predictive models, care gap automation) to improve Star Ratings outcomes.
• Mentor junior analysts and build staff on Epic quality measure architecture best practices.

• Bachelor's degree in Health Informatics, Information Systems, Computer Science, or related field (or equivalent experience).
• 5+ years of experience with Epic, including hands-on work in Healthy Planet, Clarity/Caboodle, Reporting Workbench, or SlicerDicer.
• Demonstrated experience supporting Medicare Star Ratings, HEDIS, and/or NCQA quality measure programs.
• Strong understanding of value-based care and ACO population health operations.
• Epic certification(s) in Healthy Planet or Reporting Cadence, ClinDoc, or related modules strongly preferred.
• Experience translating clinical/quality specifications into technical build requirements.
• Familiarity with FHIR/HL7 interoperability standards.

• Experience with agile delivery tools (e.g., Rally) for managing build backlogs and release planning.
• Prior experience in a health plan, ACO, or integrated delivery network environment.
• Knowledge of risk adjustment and quality reporting vendor platforms.
• Strong presentation and stakeholder management skills, with experience briefing senior leadership.

• Technical depth balanced with strategic, big-picture thinking
• Strong cross-functional collaboration across IT, clinical, and quality teams
• Analytical rigor and attention to detail in measure logic and data validation
• Clear written and verbal communication of complex technical concepts to non-technical stakeholders

The typical pay range for this role is: